OJRad  Vol.2 No.1 , March 2012
CT Findings in Patients Affected by H1N1 Influenza Virus
ABSTRACT
Objectives: To evaluate the primary lesions, the complications and the evolution of disease in patients affected by H1N1 viral infection. Materials and Methods: 24 Patients affected by H1N1 infection, diagnosed by polymerase chain reaction (PCR) on throat swabs, underwent CT examination. Seven patients were hospitalized in intensive care unit (ICU). In five patients the evolution of disease was monitored. The following features were evaluated: primary lesions significant for viral infection, their possible complications and the evolution of disease in controlled patients. Results: Primary lesions variously associated with each other were found in 22 out of 24 patients: ground glass opacities (19/24, 79.2%), interstitial thickening (13/24, 54.2%), centrilobular nodules (3/24, 12.5%) and consolidation (8/24, 33.3%). The following complications were observed: 3 consolidations with air bronchogram, 9 pleural effusions, 7 ARDS and 1 barotrauma. In the 5 patients who underwent follow-up (including 3 admitted to ICU), complete resolution was demonstrated in 4 cases and focal fibrotic evolution in one case. 3 ICU patients affected by ARDS died. Conclusions: In case of H1N1 virus infection. CT is an important tool for staging the disease, recognize complications and to study disease evolution

Cite this paper
M. Lacalamita, E. Salinaro, M. Abrusci, M. Moschetta and G. Angelelli, "CT Findings in Patients Affected by H1N1 Influenza Virus," Open Journal of Radiology, Vol. 2 No. 1, 2012, pp. 25-30. doi: 10.4236/ojrad.2012.21005.
References
[1]   G. Watts, “Pandemic Flu A/H1N1 Influenza Virus: The Basics,” July 2009. http://www.bmj.com/content/339/bmj.b3046

[2]   R. Perez-Padilla, D. de la Rosa-Zamboni, S. Ponce de Leon, et al., “Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico,” The New England Journal of Medicine, Vol. 361, No. 7, 2009, pp. 680-689.

[3]   World Health Organization, “Human Infection with Pandemic (H1N1) 2009 Virus: Updated Interim WHO Guidance on Global Surveillance,” July 2009. http://www.who.int/csr/resources/publications/swineflu/interim_guidance/en/index.html

[4]   Circolare del Ministero della Salute, “Prevenzione e Controllo Dell’Influenza: Raccomandazioni per la Stagione 2010-2011,” July 2010. http://www.normativasanitaria.it/normsan-pdf/0000/34861_1.pdf

[5]   Centers for Disease Control and Prevention “People at High Risk of Developing Flu-Related Complications,” November 2009. http://www.cdc.gov/h1n1flu/highrisk.htm.

[6]   D. M. Hansell, A. A. Bankier, H. MacMahon, B. Bao, T. C. McLoud, N. L. Müller and J. Remy, “Fleischner Society: Glossary of Terms for Thoracic Imaging,” Radiology, Vol. 246, No. 3, 2008, pp. 697-722. doi:10.1148/radiol.2462070712

[7]   E. Busi Rizzi, V. Schininà, F. Ferraro, L. Rovighi, M. Cristoforo, D. Chiappetta, F. Lisena, F. Lauria and C. Bibbolino, “Radiological Findings of Pneumonia in Patients with Swinw-Origin Influenza A Virus (H1N1),” La Radiologia Medica, Vol. 115, No. 4, 2010, pp. 507- 515. doi:10.1007/s11547-010-0553-9

[8]   P. Agarwal, S. Cinti and E. A. Kazerooni, “Chest Radiographic and CT Findings in Novel Swine-Origin Influenza A (H1N1) Virus (S-OIV) Infection,” American Jour- nal of Roentgenology, Vol. 193, No. 6, 2009, pp. 1488- 1493. doi:10.2214/AJR.09.3599

[9]   A. M. Ajlan, B. Quiney, S. Nicolaou and N. L. Müller, “Swine-Origin Influenza A (H1N1) Viral Infection: Radiographic and CT Findings,” American Journal of Roentgenology, Vol. 193, No. 6, 2009, pp. 1494-1499. doi:10.2214/AJR.09.3625

[10]   B. M. Elicker, B. S. Schwartz, C. Liu, E. C. Chen, S. A. Miller, C. Y. Chiu and W. Richard Webb, “Thoracic CT Findings of Novel Influenza A (H1N1) Infection in Immunocompromised Patients,” Emergency Radiology, Vol. 17, No. 4, 2010, pp. 299-307. doi:10.1007/s10140-010-0859-x

[11]   M. Coppola, A. Porto, D. De Santo, S. De Fronzo, R. Grassi and A. Rotondo, “Influenza A Virus: Radiological and Clinical Findings of Patients Hospitalised for Pandemic H1N1 Influenza,” La Radiologia Medica, Vol. 116, No. 5, 2011, pp. 706-719. doi:10.1007/s11547-011-0622-0

[12]   T. Valente, F. Lassandro, M. Marino, F. Squillante, M. Aliperta and R. Muto, “H1N1 Pneumonia: Our Experience in 50 Patients with a Severe Clinical Course of Novel Swine-Origin Influenza A (H1N1) Virus (S-OIV),” La Radiologia Medica, Vol. 116, No. 7, 2011, pp. 989- 1152.

[13]   G. Mineo, F. Ciccarese, C. Modolon, M. P. Landini, M. Valentino and M. Zompatori, “Post-ARDS Pulmonary Fibrosis in Patients with H1N1 Pneumonia: Role of Follow-Up CT,” La Radiologia Medica, Vol. 116, No. 7, 2011, pp. 989-1152.

[14]   D. J. Mollura, D. S. Asnis, R. S. Crupi, et al., “Imaging Findings in a Fatal Case of Pandemic Swine-Origin Influenza A (H1N1),” American Journal of Roentgenology, Vol. 193, No. 6, 2009, pp. 1500-1503. doi:10.2214/AJR.09.3365

[15]   J. Vilar, M. L. Domingo, C. Soto and J. Cogollos, “Radiology of Bacterial Pneumonia,” European Journal of Radiology, Vol. 51, No. 2, 2004, pp. 102-113. doi:10.1016/j.ejrad.2004.03.010

[16]   S. Sharma, B. Maycher and G. Eschun, “Radiological Imaging in Pneumonia: Recent Innovations,” Current Opinion in Pulmonary Medicine, Vol. 13, No. 3, 2007, pp. 159-169. doi:10.1097/MCP.0b013e3280f3bff4

[17]   G. R. Bernard, A. Artigas, K. L. Brigham, J. Carlet, K. Falke, L. Hudson, M. Lamy, J. R. Legall, A. Morris and R. Spragg, “The American-European Consensus Conference on ARDS. Definitions, Mechanisms, Relevant Outcomes, and Clinical Trial Coordination,” American Journal of Respiratory and Critical Care Medicine, Vol. 149, No. 3, 1994, pp. 818-824.

[18]   H. Henry Guo, R. T. Sweeney, D. Regula and A. N. Leung, “Fatal 2009 Influenza A (H1N1) Infection, Complicated by Acute Respiratory Distress Syndrome and Pulmonary Interstitial Emphysema,” Radio Graphics, Vol. 30, 2010, pp. 327-333. doi:10.1148/rg.302095213

[19]   M. Prokop and M. Galanski, “Tomografia Spirale e Multistrato,” Elsevier-Masson, Milano, 2006.

[20]   R. Kaarteenaho1 and V. L. Kinnula Hindawi, “Diffuse Alveolar Damage: A Common Phenomenon in Progressive Interstitial Lung Disorders,” Hindawi Publishing Corporation Pulmonary Medicine, Vol. 2011, 2011, Article ID: 531302, pp. 1-10.

[21]   V. Pulkkinen, S. Bruce, J. Rintahaka, U. Hodgson, T. Laitinen, H. Alenius, V. L. Kinnula, M. Mylla¨rniemi, S. Matikainen and J. Kere, “ELMOD2, a Candidate Gene for Idiopathic Pulmonary Fibrosis, Regulates Antiviral Responses,” The FASEB Journal Research Communication, Vol. 24, No. 4, 2010, pp. 1167-1177. doi:10.1096/fj.09-138545

 
 
Top